Immediate effects of thermal-tactile stimulation on timing of swallow in idiopathic Parkinson's disease.
Affiliation
SLT Department, Adelaide and Meath Hospital, Tallaght, Dublin 24, Ireland., julie.regan@amnch.ieIssue Date
2012-02-01T10:49:15ZMeSH
AgedConfidence Intervals
Deglutition/*physiology
Deglutition Disorders/etiology/*physiopathology/therapy
Female
Fluoroscopy
Health Status Indicators
*Hot Temperature
Humans
Male
Middle Aged
Parkinson Disease/*complications/physiopathology
Prevalence
Reproducibility of Results
Statistics, Nonparametric
Time Factors
*Touch
Metadata
Show full item recordCitation
Dysphagia. 2010 Sep;25(3):207-15. Epub 2009 Aug 26.Journal
DysphagiaDOI
10.1007/s00455-009-9244-xPubMed ID
19707818Abstract
Oropharyngeal dysphagia frequently presents in people with idiopathic Parkinson's disease (IPD). Clinical sequelae of dysphagia in this group include weight loss and aspiration pneumonia, the latter of which is the leading cause of hospital admissions and death in IPD. Thermal-tactile stimulation (TTS) is a sensory technique whereby stimulation is provided to the anterior faucial pillars to speed up the pharyngeal swallow. The effects of TTS on swallowing have not yet been investigated in IPD. The aim of this study was to investigate the immediate effects of TTS on the timing of swallow in a cohort of people with IPD and known oropharyngeal dysphagia. Thirteen participants with IPD and known dysphagia attended for videofluoroscopy during which standardised volumes of liquid barium and barium paste were administered preceding and immediately subsequent to TTS. The immediate effects of TTS on swallowing were examined using oral, pharyngeal, and total transit times and pharyngeal delay times as outcome measures. TTS significantly reduced median pharyngeal transit time on fluids (0.20 s, 95% CI = 0.12-0.28, p = 0.004) and on paste (0.3 s, 95% CI = 0.08-0.66, p = 0.01). Median total transit time was also reduced on fluids (0.48 s, 95% CI = 0.00-1.17, p = 0.049) and on paste (0.52 s, 95% CI = 0.08-1.46, p = 0.033). Median pharyngeal delay time was reduced on fluids (0.20 s, 95% CI = 0.12-0.34, p = 0.002). TTS did not significantly alter median oral transit time on either fluid or paste consistency. TTS significantly reduced temporal measures of the pharyngeal phase of swallowing in the IPD population. Significant results may be attributed to the role of sensory stimulation in improving motor function in IPD, with emphasis on the impaired glossopharyngeal and vagus nerves in this population. It is still unclear whether these findings will translate into a clinically beneficial effect.Language
engISSN
1432-0460 (Electronic)0179-051X (Linking)
ae974a485f413a2113503eed53cd6c53
10.1007/s00455-009-9244-x